Weight Loss Disparities Among Hispanic and Underserved Participants, Colorado, 2015-2018.

introductionThe National Diabetes Prevention Program (DPP) is an evidence-based strategy to prevent the development of type 2 diabetes in adults at high risk through education and behavior modifications that promote weight loss. This evaluation aimed to determine if National DPP participants' weight-related outcomes varied across demographic subgroups, including sex, age, race/ethnicity, and insurance status, after controlling for program attendance and physical activity.

methodsOur cross-site evaluation used participant-level data from 11 organizations during July 2015 through June 2018. A modified Poisson regression model was used to examine the relationship between demographic subgroups, controlling for physical activity (minutes per week) and program attendance.

resultsA total of 1,007 National DPP participants were included in the analyzed sample. Participants lost an average of 4% of their initial body weight, approximately 8 pounds. About one-third of participants achieved greater than 5% weight loss. In the unadjusted estimates, participants who were Hispanic, non-Hispanic Black, young, and uninsured were significantly less likely to achieve 5% or greater weight loss. Demographic differences in achieving 5% or greater weight loss, however, were not significant after adjusting for program attendance and physical activity level.

conclusionsDisparities in National DPP weight-related outcomes were not observed across demographic groups after adjusting for program attendance and physical activity levels. However, non-Hispanic Black participants had lower attendance and Hispanic participants reported less physical activity than participants of other races/ethnicities. Strategies to improve National DPP participation and increase physical activity, therefore, should be prioritized among Hispanic and non-Hispanic Black participants.